Reproductive Rights of the Disabled

A fascinating story is developing in Chicago. A 26-year old woman’s guardian is petitioning a court to allow her to forcefully sterilize the woman. The guardian argues that because her ward is sexually active and could not take care of a child on her own, she should be sterilized through tubal ligation. The case raises issues about the rights of the disabled, of course. Should men and women who are deemed incompetent to take care of themselves be allowed to have children? If not, what means should be used to prevent their becoming pregnant, if any? Does forceful tubal ligation violate the rights of this woman?
The problem runs even deeper. Under the law, the woman’s guardian is required to care for her ward. Her job is to protect her like she would any minor child, and guardians are therefore given broad legal rights (much like parents) to make decisions on behalf of their wards. Therefore, we see here a conflict between the autonomy of the woman and the powers of the guardian.
Within bioethics, we typically recognize the value of autonomy. This basic principle of freedom is a means of granting individuals the right to make decisions concerning their own health care. Generally, this means that all competent individuals have the right to refuse any medical treatment. However, there are exceptions to the rule: parents have the right to make medical decisions for children, states and cities have the right to make medical decisions for their prisoners, and guardians have the right to make medical decisions for incompetent individuals under their supervision (an incompetent individual is one that lacks the mental or physical faculties to rationally decide for themselves).
This right to interfere with a person’s autonomy is generally known as paternalism. It is a fitting name, since the root word refers to the paternal (or parental) power over a minor child.


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A Brief Introduction to Ethics

I mentioned at our first meeting that bioethics relies on the application of ethical concepts to current issues in our field of study. Following up with that explanation, I wanted to provide some general guidelines to a few of the major ethical theories of our time. The following document is a short survey of three such theories: utilitarianism (a type of consequentialist theory), deontology, and virtue ethics. All of them will be relevant to us at some point, and each of them is best suited to different types of applications.
With this in mind, we’ll examine these theories in the following order:

1.      Utilitarian ethics

2.      Deontological ethics

3.      Virtue ethics


Utilitarian ethics – also known as consequentalism, or consequentialist ethics – measures the ethical value of an action or principle on the basis of its outcomes.  If an action or principle produces more benefits than drawbacks, then it is “right,” or “moral.”  If it produces more drawbacks than benefits, it is “wrong” or “immoral.”


Deontological ethics measures the act or principle itself for rightness or wrongness.  If an action or principle is right in itself – regardless of the consequences that it yields – then it is moral.  If it is wrong in itself – regardless of the consequences that it yields – then it is immoral. 


Consider an example: Imagine that there are five people in a hospital dying of various diseases of the major organs.  One is dying of heart disease, one of liver disease, two of kidney diseases, and one of lung disease.  A gunshot victim comes into the emergency room of the same hospital.  He is in serious condition, but can be saved by surgical intervention that should take several hours. 


Now, consider this question: Is it moral for the hospital to kill the gunshot victim, harvest his organs, and distribute those organs to the dying patients suffering from organ diseases?  Let’s look at this from the perspective of each of the two theories described above.


From the perspective of utilitarian ethics, it may well be moral.  Consider two ways of looking at the issue from the perspective of utilitarianism:


  • Act-Utilitarianism: in Act-U, we look strictly at this specific act, and ask ourselves whether performing the act would lead to greater benefits than it would drawbacks. It seems that it would: we can save five people by killing only one, therefore, it seems moral to perform this action – killing the gunshot victim and harvesting his organs – in order to save the dying patients in the other parts of the hospital.
  • Rule-Utilitarianism: In Rule-U, we look at the rule – or principle – that we would be espousing by performing the act in question.  In this case, the rule – or principle – would be something like this: When we can save more than one patient by killing one other patient, we should do so.  Next, we ask ourselves whether this rule – or principle – maximizes benefits over drawbacks.  Let’s take a look at this question from the perspective of the hospital: what if the hospital were to adopt a rule of killing patients in order to harvest their organs in situations where those organs could be used for multiple other patients?  Well, it seems the answer is obvious: no one would come to that hospital anymore!  Therefore, we need to work into our rule the drawbacks of the hospital no longer having any patients.  This would be relevant – from the Rule-Utilitarian perspective – to whether we would adopt this rule.  Therefore, it seems in this case we should not adopt the rule in question.

We now come to a very different kind of ethical theory, one that doesn’t care about consequences:  


  • Deontological ethics – What happens when we move away from the focus on outcomes and instead look at our actions themselves?  In deontology, an act or rule is either right or wrong in itself, regardless of the good or bad consequences that it generates.  So, a deontologist might argue that killing of innocent persons is wrong, period.  That would prevent us from acting to remove the organs of the gunshot victim, even if we could save five other people as a result.  Now, the deontologist still has to give an argument for such a killing being wrong – here, he has several strategies open to him:
    • Natural rights: he could argue that humans have certain natural rights, and that among these is a right to life.  This approach requires him to give some reasoning that justifies the notion of a natural right.  For example, it could be based on the natural faculties of humans: he could argue as follows – since humans have a universal desire to live, this is a desire that we should abide by.
    • Duty: the deontologist could argue that all humans have duties toward others, and that among these duties is respect for persons.  Respecting someone, furthermore, means not treating them as means toward another end.  So, in the hospital case above we would be treating that gunshot victim as a mere means toward our own ends, and therefore violating our duty of respect for others.  This is the view held by Immanuel Kant.

One last theory: 


  • Finally, we come to virtue ethics.  This view is rooted in the notion of character, and holds that instead of focusing on acts or rules, we should instead seek to improve our individual character.  Under this view, we put forth a list of valued virtues and seek to make them our own.  So, for example, we can imagine that “Justice” is a virtue, and therefore seek to make ourselves into a just individual.  How?  Presumably by practice – practice is the usual way that we become what we want to be.  We define a goal, and then proceed to develop it into a habit, thus embedding it into our character.  Or, we pick honesty as the virtue we want to have, and we attempt to develop ourselves into honest individuals by practicing honesty on a regular basis.  Thus, by developing honest habits we come to possess the virtue of honesty.  Now, how does this relate to our hospital example?  There’s no easy answer here, because the list of valued virtues is not easy to define; but we would ask questions like “Would an honest person do this?” or “Would a just individual kill one human in order to save several others?”



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Peter Singer’s "All Animals are Equal"

This is the paper I handed out (to some of you) at our first meeting. It can be found at the following address:

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The Schiavo Case and the Right to Die

The Terri Schiavo case gripped the U.S. for several months and took 15 years to resolve. Why did it take so long? What was at stake? What were the ethical issues involved in this case, and do all states deal with death as Florida dealt with it?

Documentation of the Schiavo case can be found here:

The case is also indicative of a broader trend all over the world to grant patients a right to die. Michael Schiavo, Terri’s husband, claimed repeatedly that Terri had told him that she did not want to live in a vegetative state. Several questions arise at this point:

  • Should a person be required to make his/her wishes about terminal treatment known in writing?
  • Should family members have the right to make decisions concerning the end-of-life care of their kin?
  • Does Oregon’s assisted suicide law go too far in granting a right to die? Should active voluntary euthanasia be legal? If so, what restrictions should apply to patients?
  • Has Holland gone too far with its euthanasia law? Does the recent finding about the passive involuntary euthanasia of infants prove that there is an unavoidable slippery slope when societies legalize forms of suicide?
  • Should passive (involuntary) euthanasia of minors with disabilities be legal in any case? Should it be legal to euthanize infants solely because of a handicap that is not immediately life-threatening?
  • How should nutrition and hydration be treated in end-of-life care? Given that patients have the right to refuse treatment (including food and water) should their relatives have the same right even if they do not know the wishes of the patient concerning nutrition and hydration support?

We’ll examine the arguments in response to all of these issues.

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Online Resources: Logic and Arguments

Our main resource should be the Introductory chapter of the Solomon text, Section D. However, there are several good online sites describing basic logic and the logic of arguments. Here are some of them:

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Definitions of Science

I came across the following recently. I thought it would make a good discussion topic. The definition of science (if there is a single “correct” definition) seems a crucial step towards the proper understanding of truth. Is science the sole guardian of truth? What relationships exist between science as a collection of facts and moral truth, if any? Can science help find God, or is this a foolish attempt that relies on a misunderstanding of terms? 
One famous definition of science is Karl Popper’s: Science deals with falsifiable statements. A “falsifiable statement” is a statement capable of being determined true or false on the basis of observation. In other words, a statement such as “The table is on the floor” is falsifiable because we can observe our surroundings and make a determination as to the statement’s truth. On the other hand, a statement like “God exists” is not falsifiable because there is no possible observation that would prove the statement false. Popper puts it this way:
  • I think that we shall have to get accustomed to the idea that we must not look upon science as a “body of knowledge”, but rather as a system of hypotheses, or as a system of guesses or anticipations that in principle cannot be justified, but with which we work as long as they stand up to tests, and of which we are never justified in saying that we know they are “true”… (from The Logic of Scientific Discovery).
In other words, it is not “truth” that science seeks, but the removal of unjustified statements that do not stand up to the “right tests.”

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Free Will and Determinism

Are we free to choose our actions? Do humans possess freedom that other creatures do not? Does science determine human actions? Does God determine them? Are the concepts of “freedom” and “determinism” compatible with one another?
These and other issues have been discussed over the last several hundred years in the course of the free will debate. The central philosophical problem concerns the fact that physical events appear to be fully deterministic: they are driven by causal laws that never change. On the other hand, humans appear to be free creatures: they choose their behavior. These two apparent facts appear to be at loggerheads.
The problem can also be found in theology: if God is omniscient (all-knowing) and omnipotent (all-powerful), then how can human beings be free to choose their behavior? It would seem that if God is all-knowing, he knows what we will do before we do it. This finding seems to contradict the possibility of freedom.
Issues: See above.

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Intelligent Design

The debate over ID is raging. Intelligent Design is the theory that there are entities so complex that they must have been intelligently designed. A frequent extension of the theory is that such entities could not have evolved in the way that the theory of evolution says they evolved (through a large number of minor changes in physiology occurring over millions of years). Some schools, districts, and states want to teach ID in science classrooms, and this has generated a backlash among those who believe that such a move would violate the separation of church and state.
To understand ID, one needs to understand the science of evolution and the theoretical claims that proponents of ID are making. So, we begin with a summary of evolution theory. Then, a scientific debate on ID. Finally, some additional arguments, mostly on the political issues involved. 
Some of the issues raised by this topic are…
  • Should ID be taught in public classrooms at all? If so, is it appropriate to include it in the science curriculum, or should it be moved to a philosophy or religious study course?
  • Is ID a scientific theory?
  • Must the universe have an intelligent designer, or is it possible for the universe’s complexity to have evolved without such a designer?

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Philosophy and Films

I wanted to start this topic to get some movie recommendations going. Alex (in the 2PM class) recommends “Waking Life.” I have it, haven’t seen it, and am interested to hear what others might have to say about the philosophical issues behind the film. Would it be a good selection? What other choices come to mind?

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A pretty good example of a health-related argument. It would be a challenge to diagram, I think.

Here’s the link:

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